Bronchitis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
Acute Bronchitis usually presents with cough with or without [[sputum]]. The symptoms generally gets well within 10 days but may last for 4 weeks or more. Patients with recurrent episodes of acute bronchitis should be tested to rule out [[asthma]].
Acute bronchitis is usually a self limiting disease with excellent prognosis but chronic bronchitis is a long lasting disease with variable outcomes depending on the severity of airflow obstruction with multiple complications.


==Natural History==
==Natural History==
 
'''Acute bronchitis''' is a self limiting lower respiratory tract infection usually presents with cough that lasts for up to 3 weeks<ref name="pmid11119400">{{cite journal |vauthors=Gonzales R, Sande MA |title=Uncomplicated acute bronchitis |journal=Ann. Intern. Med. |volume=133 |issue=12 |pages=981–91 |year=2000 |pmid=11119400 |doi= |url=}}</ref><ref name="pmid16798599">{{cite journal |vauthors=Landau LI |title=Acute and chronic cough |journal=Paediatr Respir Rev |volume=7 Suppl 1 |issue= |pages=S64–7 |year=2006 |pmid=16798599 |doi=10.1016/j.prrv.2006.04.172 |url=}}</ref>.<br>'''Chronic bronchitis''' usually gradually gets worse over time and can lead to death. The rate at which it gets worse varies between individuals and depends on the level of airflow obstruction.
Acute bronchitis usually presents with cough with or without sputum. Since, acute bronchitis has similar presentation as many other respiratory infections it is difficult to distinguish it from upper respiratory tract infection initially. However, unlike other [[upper respiratory tract infection]]s the cough usually lasts for more than 5 days in acute bronchitis. It usually last for more than 10-20 days and occasionally more than one month. If the symptoms persist it may also give difficulties in abnormal pulmonary function tests (forced expiratory volume in 1 second and bronchial provocation test). Some studies have found that patients presenting with recurrent episodes of bronchitis were later as diagnosed to have asthma.
==Prognosis==
'''Acute bronchitis''' has very excellent prognosis<ref name="pmid17108344">{{cite journal |vauthors=Wenzel RP, Fowler AA |title=Clinical practice. Acute bronchitis |journal=N. Engl. J. Med. |volume=355 |issue=20 |pages=2125–30 |year=2006 |pmid=17108344 |doi=10.1056/NEJMcp061493 |url=}}</ref>.'''Chronic bronchitis''' however is dependent on early recognition and smoking cessation which improves the outcome significantly.


==Complications==
==Complications==
[[Pneumonia]] can develop from either [[acute]] or [[chronic bronchitis]]. If you have [[chronic bronchitis]], you are more likely to develop recurrent [[respiratory]] [[infections]]. You may also develop:
The most common complication of '''[[acute Bronchitis]]''' is persistent cough that my last for 6 weeks<ref name="pmid17108344">{{cite journal |vauthors=Wenzel RP, Fowler AA |title=Clinical practice. Acute bronchitis |journal=N. Engl. J. Med. |volume=355 |issue=20 |pages=2125–30 |year=2006 |pmid=17108344 |doi=10.1056/NEJMcp061493 |url=}}</ref>.Rarely, in patients with immunosuppression or other debilitating disease, [[Pneumonia]] occurs as a complication<ref name="pmid21121518">{{cite journal |vauthors=Albert RH |title=Diagnosis and treatment of acute bronchitis |journal=Am Fam Physician |volume=82 |issue=11 |pages=1345–50 |year=2010 |pmid=21121518 |doi= |url=}}</ref>.
*[[Emphysema (patient information)|Emphysema]]
Recurrent pneumonia is a common complication of '''chronic bronchitis''' and a frequent cause of exacerbation. Cor pulmonale is right-sided heart failure secondary to longstanding COPD. It is
*Right-sided [[Congestive heart failure (patient information)|heart failure]] or [[cor pulmonale]]
caused by chronic hypoxia and subsequent vasoconstriction in pulmonary vasculature that causes pulmonary hypertension and right-sided heart failure. Depression is a common consequence of chronic bronchitis<ref name="pmid11281745">{{cite journal |vauthors=Bach PB, Brown C, Gelfand SE, McCrory DC |title=Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence |journal=Ann. Intern. Med. |volume=134 |issue=7 |pages=600–20 |year=2001 |pmid=11281745 |doi= |url=}}</ref>.
*[[Pulmonary hypertension (patient information)|Pulmonary hypertension]]
 
==Prognosis==
Acute bronchitis usually lasts approximately 20 or 30 days. It may accompany or closely follow a cold or the flu, or  may occur on its own. Bronchitis usually begins with a [[dry cough]], including waking the sufferer at night. After a few  days it progresses to a wetter or productive cough, which may be accompanied by [[fever]], [[fatigue]], and [[headache]]. The fever, fatigue, and [[malaise]] may last only a few days; but the wet cough may last up to several weeks.
 
Should the cough last longer than a month, some doctors may issue a referral to an otolaryngologist (ear, nose and throat doctor) to see if a condition other than bronchitis is causing the irritation. It is possible that having irritated bronchial tubes for as long as a few months may inspire asthmatic conditions in some patients.
 
In addition, if one starts coughing  mucus tinged with blood, one should see a doctor. In rare cases, doctors may conduct tests to see if the cause is a serious condition such as [[tuberculosis]] or [[lung cancer]].


==References==
==References==

Revision as of 19:32, 14 September 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Bronchitis Main page

Patient Information

Overview

Causes

Classification

Acute bronchitis
Chronic bronchitis

Differential Diagnosis

Overview

Acute bronchitis is usually a self limiting disease with excellent prognosis but chronic bronchitis is a long lasting disease with variable outcomes depending on the severity of airflow obstruction with multiple complications.

Natural History

Acute bronchitis is a self limiting lower respiratory tract infection usually presents with cough that lasts for up to 3 weeks[1][2].
Chronic bronchitis usually gradually gets worse over time and can lead to death. The rate at which it gets worse varies between individuals and depends on the level of airflow obstruction.

Prognosis

Acute bronchitis has very excellent prognosis[3].Chronic bronchitis however is dependent on early recognition and smoking cessation which improves the outcome significantly.

Complications

The most common complication of acute Bronchitis is persistent cough that my last for 6 weeks[3].Rarely, in patients with immunosuppression or other debilitating disease, Pneumonia occurs as a complication[4]. Recurrent pneumonia is a common complication of chronic bronchitis and a frequent cause of exacerbation. Cor pulmonale is right-sided heart failure secondary to longstanding COPD. It is caused by chronic hypoxia and subsequent vasoconstriction in pulmonary vasculature that causes pulmonary hypertension and right-sided heart failure. Depression is a common consequence of chronic bronchitis[5].

References

  1. ↑ Gonzales R, Sande MA (2000). "Uncomplicated acute bronchitis". Ann. Intern. Med. 133 (12): 981–91. PMID 11119400.
  2. ↑ Landau LI (2006). "Acute and chronic cough". Paediatr Respir Rev. 7 Suppl 1: S64–7. doi:10.1016/j.prrv.2006.04.172. PMID 16798599.
  3. ↑ 3.0 3.1 Wenzel RP, Fowler AA (2006). "Clinical practice. Acute bronchitis". N. Engl. J. Med. 355 (20): 2125–30. doi:10.1056/NEJMcp061493. PMID 17108344.
  4. ↑ Albert RH (2010). "Diagnosis and treatment of acute bronchitis". Am Fam Physician. 82 (11): 1345–50. PMID 21121518.
  5. ↑ Bach PB, Brown C, Gelfand SE, McCrory DC (2001). "Management of acute exacerbations of chronic obstructive pulmonary disease: a summary and appraisal of published evidence". Ann. Intern. Med. 134 (7): 600–20. PMID 11281745.


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